Dr. Gautam Banga is the best doctor in Delhi and have huge reputation on Hypospadias Treatment. Opening of the urethra at a location other than the tip of the penis. Abnormal spraying during urination. Downward curve of the penis (chordee). Hooded appearance of the penis as only the top half of the penis is covered by foreskin. Hypospadias Treatment influence's a Man’s psycho-social status. Affected man often feels like he has got this horrible secret in his pants and if others will find out, they would make fun of him. Hypospadias leads to shame and aloneness that a guy can feel when he’s growing up. One of the reasons for feeling so different is because he needs to sit down to pee unlike other males.

1. Hypospadias tREATMENT:
An illustrated guide
Dr.Gautam Banga
MBBS, MS, M.Ch (Urology)
Urologist, Andrologist & Genito-Urinary Reconstructive
Surgeon

2. What is Hypospadias
 A birth defect in baby boy in which the
penis neither works well nor looks
normal.
 It is the defect of the urethra in the
male where the urinary opening is not
at the usual location on the head of
the penis.
 It is the second most common birth
abnormality in boys, affecting
approximately 1 of every 250 new
born boys.

3. CAUSES
The exact reason of this defect is
unknown. Sometimes hypospadias is
genetic.

4. Signs and Symptoms
 Opening of the urethra at a location
other than the tip of the penis.
 Abnormal spraying during urination.
 Downward curve of the penis
(chordee).
 Hooded appearance of the penis as
only the top half of the penis is
covered by foreskin.

5. Hypospadias if untreated
influence a Man’s psycho-social
status Affected man often feels like he has got this
horrible secret in his pants and if others will
find out, they would make fun of him.
 Hypospadias leads to shame and
aloneness that a guy can feel when he’s
growing up.
 One of the reasons for feeling so different is
because he needs to sit down to pee unlike
other males.

6. Hypospadias Treatment if not
taken
1. Irregular urine stream .He would have to pee
sitting down his whole life.
2. His penis would look different than other
boys.
3. It could potentially create fertility issues. The
opening of the penis is not close to the cervix as
a result of which the sperm is not in the right
place to cause pregnancy.
4. If the penis has chordee (downward
curvature of the penis) it becomes very painful,
difficult or even impossible to have intercourse
as an adult.

7. Surgical Hypospadias
Treatment
 If the Hypospadias needs to be repaired, this
is done by surgery.
 The aim is to repair and reconstruct the
urethra. Depending on the degree of the
hypospadias, the surgery can range from
relatively simple to very challenging.
 It is usually performed by the paediatric
urologist when the baby is between 6 to 15
months old.
 The surgery is safe and well tolerated, and a
good outcome with a normal or near normal,
penis appearance and function can be
achieved.

8. Post- surgical complications
 Pain: but manageable.
 Spasms: due to irritation by the catheter- a small dose of
bladder relaxant is usually prescribed.
 Blood spotting : A few drops of the blood are acceptable.
 Dressing loosening up : If it happens during first 2-3 days,
then a new dressing is placed.
 Infection : most common cause of the failure of surgery-
broad spectrum antibiotic syrup is usually prescribed for 7-10
days
 Fistula: may heal in due course of time.
 Stenosis/ Stricture: During healing period, the new urinary
tube may become tight which can be easily managed by
daily calibration at home with a small feeding tube.
These complications are typically 5% if the surgery is

9. Adult hypospadias/ Re-do
hypospadias Treatment
 Most cases of adult hypospadias are those who
live with hypospadias all their life because of their
misbelief that there was nothing to be done about
it when they were infants.
 Also the adult patient with hypospadias ignores
the disease as he is already into middle age now.
He had his children.
 But such patients should be educated about
connecting adult hypospadias with chronic
prostatitis and urinary tract infections, painful
intercourse, abnormal look of penis.
 This is absolutely treatable disorder. Such patient
can have a normal penis. He can pee normally
and not spray all over the place. He can have
pain free sex.

10. Hypospadias repair surgery in adults-
Differences from surgery in children
 Longer healing time than children: It may take upto 2-3
months for the penis skin to heal fully.
 Longer time for indwelling urine catheter: Catheter is kept
inside for 10-14 days for distal hypospadias repair in adults
and 14-21 days for severe hypospadias repair in adults.
 Higher risk of infections: as there is hair growth in penile
area and more sweating in adults.
 Pain after surgery: as adults have night time erections
during a certain phase of the sleep.
 Abstinence from sex: for almost 3 months
 Off from work: 4 weeks off from work
 Uroflowmetery: to check the speed of urine passage at 3
months and one year of surgery to make sure that the new
passage is of good caliber.

11. Hypospadias cripples
 ‘Hypospadias cripples’ is the case when even after
hypospadias repair some functional complications
prevail in patient .
 This condition is a challenge to reconstructive surgeons
because of the complexity of the problem and limited
options for reconstruction.
 These patients have usually undergone multiple urethral
surgeries leaving the blood supply compromised and
healthy tissue scarce.
 Given the variability involved in Re-do hypospadias
repair, the reconstructive urologist should be familiar
with several techniques. A number of surgical
techniques are available for Re-do hypospadias repairs.

12. RESULT
 Generally with current hypospadias surgical techniques
preserving nerve and blood supply, the hypospadias repairs
have resulted in very good outcomes both from cosmetic and
functional perspective.
 Currently, more than 90% of the children with penile
hypospadias get successful results after single stage
hypospadias surgery and children are able to stand and pee
like a normal kid a few days after surgery.
 If there has been any bend in penis, that is corrected leading
to straight penis after hypospadias repair. So in nutshell, in
most of the cases a few weeks after surgery, penis looks like
just that a circumcision has been done.
 A check-up is mandatory later on after puberty at about 13-24
years of age and after 2-3 years of sexual life/ marriage to
ensure that the urethra is functioning well.

13. SCI International Hospital
M-4, Greater Kailash-1, New Delhi-110048
www.urethraandpenilesurgery.com
www.scihospital.com